Comparative effectiveness of teriflunomide and dimethyl fumarate: A nationwide cohort study
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Standard
Comparative effectiveness of teriflunomide and dimethyl fumarate : A nationwide cohort study. / Buron, Mathias Due; Chalmer, Thor Ameri; Sellebjerg, Finn; Frederiksen, Jette; Góra, Monika Katarzyna; Illes, Zsolt; Kant, Matthias; Mezei, Zsolt; Petersen, Thor; Rasmussen, Peter Vestergaard; Roshanisefat, Homayoun; Hassanpour-Kalam-Roudy, Houry; Sejbæk, Tobias; Tsakiri, Anna; Weglewski, Arkadiusz; Sorensen, Per Soelberg; Magyari, Melinda.
I: Neurology, Bind 92, Nr. 16, 2019, s. e1811-e1820.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Comparative effectiveness of teriflunomide and dimethyl fumarate
T2 - A nationwide cohort study
AU - Buron, Mathias Due
AU - Chalmer, Thor Ameri
AU - Sellebjerg, Finn
AU - Frederiksen, Jette
AU - Góra, Monika Katarzyna
AU - Illes, Zsolt
AU - Kant, Matthias
AU - Mezei, Zsolt
AU - Petersen, Thor
AU - Rasmussen, Peter Vestergaard
AU - Roshanisefat, Homayoun
AU - Hassanpour-Kalam-Roudy, Houry
AU - Sejbæk, Tobias
AU - Tsakiri, Anna
AU - Weglewski, Arkadiusz
AU - Sorensen, Per Soelberg
AU - Magyari, Melinda
N1 - © 2019 American Academy of Neurology.
PY - 2019
Y1 - 2019
N2 - OBJECTIVE: To compare on-treatment efficacy and discontinuation outcomes in teriflunomide (TFL) and dimethyl fumarate (DMF) in the treatment of relapsing-remitting multiple sclerosis (RRMS) in a real-world setting.METHODS: We identified all patients starting TFL or DMF from the Danish Multiple Sclerosis Registry and compared on-treatment efficacy outcomes between DMF using TFL, adjusted for clinical baseline variables and propensity score-based methods.RESULTS: We included 2,236 patients in the study: 1,469 patients on TFL and 767 on DMF. Annualized relapse rates (ARRs) in TFL and DMF were 0.16 (95% confidence interval [CI] 0.13-0.20) and 0.09 (95% CI 0.07-0.12), respectively. Relapse rate ratio for DMF/TFL was 0.58 (95% CI 0.46-0.73, p < 0.001). DMF had a higher relapse-free survival proportion at 48 months of follow-up (p < 0.05). We observed no difference in Expanded Disability Status Scale score worsening. Discontinuations due to disease breakthrough were 10.2% (95% CI 7.6%-12.8%) and 22.1% (95% CI 19.2%-25.0%) for DMF and TFL, respectively. A subgroup analysis of ARRs in 708 patients with available baseline MRI T2 lesion amount reported similar results after adjustment.CONCLUSION: We found lower ARR, higher relapse-free survival, and lower incidence of discontinuation due to disease breakthrough on treatment with DMF compared with TFL.CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that for patients with RRMS, DMF is more effective in preventing relapses and has lower discontinuation due to disease breakthrough compared with TFL.
AB - OBJECTIVE: To compare on-treatment efficacy and discontinuation outcomes in teriflunomide (TFL) and dimethyl fumarate (DMF) in the treatment of relapsing-remitting multiple sclerosis (RRMS) in a real-world setting.METHODS: We identified all patients starting TFL or DMF from the Danish Multiple Sclerosis Registry and compared on-treatment efficacy outcomes between DMF using TFL, adjusted for clinical baseline variables and propensity score-based methods.RESULTS: We included 2,236 patients in the study: 1,469 patients on TFL and 767 on DMF. Annualized relapse rates (ARRs) in TFL and DMF were 0.16 (95% confidence interval [CI] 0.13-0.20) and 0.09 (95% CI 0.07-0.12), respectively. Relapse rate ratio for DMF/TFL was 0.58 (95% CI 0.46-0.73, p < 0.001). DMF had a higher relapse-free survival proportion at 48 months of follow-up (p < 0.05). We observed no difference in Expanded Disability Status Scale score worsening. Discontinuations due to disease breakthrough were 10.2% (95% CI 7.6%-12.8%) and 22.1% (95% CI 19.2%-25.0%) for DMF and TFL, respectively. A subgroup analysis of ARRs in 708 patients with available baseline MRI T2 lesion amount reported similar results after adjustment.CONCLUSION: We found lower ARR, higher relapse-free survival, and lower incidence of discontinuation due to disease breakthrough on treatment with DMF compared with TFL.CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that for patients with RRMS, DMF is more effective in preventing relapses and has lower discontinuation due to disease breakthrough compared with TFL.
KW - Adult
KW - Cohort Studies
KW - Crotonates/therapeutic use
KW - Denmark
KW - Dimethyl Fumarate/therapeutic use
KW - Disability Evaluation
KW - Female
KW - Humans
KW - Immunosuppressive Agents/therapeutic use
KW - Male
KW - Multiple Sclerosis, Relapsing-Remitting/drug therapy
KW - Survival
KW - Toluidines/therapeutic use
KW - Treatment Outcome
U2 - 10.1212/WNL.0000000000007314
DO - 10.1212/WNL.0000000000007314
M3 - Journal article
C2 - 30877188
VL - 92
SP - e1811-e1820
JO - Neurology
JF - Neurology
SN - 0028-3878
IS - 16
ER -
ID: 236609363